Provider Demographics
NPI:1679617310
Name:COONER, STEVEN (LAC LMT OMD PHD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:COONER
Suffix:
Gender:M
Credentials:LAC LMT OMD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 N 73RD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251
Mailing Address - Country:US
Mailing Address - Phone:602-625-6612
Mailing Address - Fax:480-945-9053
Practice Address - Street 1:3080 N CIVIC CT PLAZA
Practice Address - Street 2:SUITE 12
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251
Practice Address - Country:US
Practice Address - Phone:602-625-6612
Practice Address - Fax:480-945-9053
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0103171100000X
VT0910000028171100000X
AZMT03746P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist